ONS Connect - June 2008 - (Page 22)

FIVEMINUTEINSERVICE As seen in tHe CliniCal Journal of onCology nursing AnD onCology nursing forum Manage Skin Toxicities Associated With EGFR Inhibitors [By elisa Becze, BA, ONS Staff Writer] s targeted therapies such as epidermal growth factor receptor (EGFR) inhibitors are used with increasing frequency, side effects associated with the treatments, such as rashes and skin reactions, will be seen more commonly as well. Two recent articles, Oishi (2008) in the Oncology Nursing Forum and Eaby, Culkin, and Lacouture (2008) in the Clinical Journal of Oncology Nursing, addressed nursing considerations for and management of patients experiencing EGFR inhibitor–associated skin conditions. Eaby et al. also reported on the outcomes of an interdisciplinary forum held in October 2006 to discuss EGFR inhibitor–associated skin toxicities. Skin toxicities are a common side effect of EGFR inhibitors because EGFR is involved with normal skin development and function (Oishi, 2008). The most commonly reported toxicity is a mild to moderate rash, but its incidence varies depending on the therapy, from 37% with gefitinib to 80%–90% with cetuximab and panitumumab (Oishi). Some evidence suggests that the presence of a skin rash is a marker of efficacy for EGFR inhibitors (Eaby et al., 2008). Other common skin reactions are xerosis, pruritus, nail changes, mild hair loss, and hypertrichosis (Eaby et al.; Oishi). See Table 1 for incidence rates. According to Eaby et al. (2008), as of yet, no data from controlled clinical A Key Definitions Epidermal growth factor receptor (EGFR): a member of the human epidermal receptor family that is implicated in the development and function of normal and cancer cells EGFR inhibitor: inhibitor of EGFR that is responsible for suppressing proliferation, progression, and survival of cancer cells Monoclonal antibodies: a class of EGFR inhibitors that includes, among others, cetuximab (Erbitux ®, ImClone Systems, Inc.) and panitumumab (Vectibix®, Amgen Inc.) Tyrosine kinase inhibitors: a class of EGFR inhibitors that includes, among others, erlotinib (Tarceva®, Genentech), gefitinib (Iressa®, AstraZeneca), and lapatinib (Tykerb®, GlaxoSmithKline) studies investigating treatment options for EGFR inhibitor–associated skin toxicities have been published; therefore, no peer-reviewed, evidence-based treatment recommendations can be made. The interdisciplinary forum was conducted to develop a consensus approach to treatment. Skin Rash EGFR inhibitor–associated rashes can be maculopapular, follicular, or pustu- Five-Minute In-Service is a monthly feature that offers readers a concise recap of a full-length article published in the Clinical Journal of Oncology Nursing (CJON) or Oncology Nursing Forum (ONF). This edition summarizes “Clinical Approaches to Minimize Rash Associated with EGFR Inhibitors” by Karen Oishi, APRN, MSN, GNP-C, ANP-C, OCN®, which was featured in the January 2008 issue of ONF and “An Interdisciplinary Consensus on Managing Skin Reactions Associated With Human Epidermal Growth Factor Receptor Inhibitors” by Beth Eaby, MSN, CRNP, OCN®, Ann Culkin, RN, OCN®, and Mario E. Lacouture, MD, which was featured in the April 2008 issue of CJON. Questions regarding the information presented in this Five-Minute In-Service should be directed to the ONF editor at ONFEditor@ons .org or the CJON editor at CJONEditor@ons.org. Photocopying of this article for educational purposes and group discussion is permitted. 22 ONS CONNECT June 2008

Table of Contents Feed for the Digital Edition of ONS Connect - June 2008

ONS Connect - June 2008 Contents Editor's Note Just In They Have a Dream A Year in the Life—Month Six Web Connect Capitol Connection Notice Nursing Now Caregiver Care Manage Skin Toxicities Associated With EGFR Inhibitors Blood Test for Ovarian Cancer May Be 99 Percent Accurate Calendar of Events Working For You Staying On Top

ONS Connect - June 2008

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.